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目的:探讨补肾活血汤治疗肾虚血瘀型老年骨质疏松症患者的疗效机制。方法:将110例老年骨质疏松症患者随机分为2组各55例。2组均予阿法骨化醇胶丸治疗,观察组再予补肾活血汤治疗。观察2组治疗前后中医证候积分、骨钙素(BGP)、抗酒石酸碱性磷酸酶(TRACP-5b)的变化,评估其疗效及安全性。结果:治疗后2组中医证候积分均低于治疗前(P<0.01),治疗后观察组中医证候积分低于同期对照组(P<0.05)。治疗后2组腰椎、股骨颈骨密度均高于同组治疗前(P<0.05),治疗后观察组腰椎、股骨颈骨密度均高于对照组(P<0.05)。治疗后2组患者血清中BGP水平均高于本组治疗前(P<0.05),而TRACP-5b水平高于本组治疗前(P<0.05)。治疗后观察组患者血清中BGP水平均高于同期对照组(P<0.05),而TRACP-5b水平低于同期对照组(P<0.05)。总有效率对照组78.2%,观察组92.7%,2组比较,差异有统计学意义(χ2=4.681,P=0.031<0.05)。结论:补肾活血汤治疗肾虚血瘀型老年骨质疏松症安全有效,能有效提高患者骨密度及改善骨代谢水平。
Objective: To investigate the therapeutic effect of Bushen Huoxue Decoction on senile osteoporosis patients with kidney deficiency and blood stasis syndrome. Methods: 110 elderly patients with osteoporosis were randomly divided into two groups of 55 cases. Both groups were treated with alfacalcidol, and the observation group was treated with Bushen Huoxue Decoction. The changes of TCM syndrome score, BGP and TRACP-5b before and after treatment were observed before and after treatment to evaluate the curative effect and safety. Results: After treatment, the scores of TCM syndromes in both groups were lower than those before treatment (P <0.01). After treatment, the scores of TCM syndromes in the observation group were lower than those in the same period (P <0.05). The BMD of lumbar spine and femoral neck in the two groups after treatment was significantly higher than that of the control group before treatment (P <0.05). After treatment, the BMD of the lumbar and femoral neck in the observation group was higher than that of the control group (P <0.05). The levels of BGP in serum of the two groups after treatment were significantly higher than those before treatment (P <0.05), while the levels of TRACP-5b were higher than those before treatment (P <0.05). The level of BGP in the serum of observation group was higher than that of the control group (P <0.05), while the level of TRACP-5b was lower than that of the control group (P <0.05). The total effective rate was 78.2% in the control group and 92.7% in the observation group. There was significant difference between the two groups (χ2 = 4.681, P = 0.031 <0.05). Conclusion: Bushen Huoxue Decoction is safe and effective in treating senile osteoporosis with deficiency of kidney and blood stasis, which can effectively improve bone mineral density and improve bone metabolism.